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Biologic Therapy with or Without Topical Treatment in Psoriasis: What Does the Current Evidence Say?

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Abstract

Biologic therapy represents a relatively new class of drugs which have revolutionized the treatment of psoriasis and are used with increasing frequency in order to control this chronic, systemic inflammatory disease. However, it is unclear what role there is for combination therapy of biologics with traditional topical agents. The purpose of this article is to assess the literature on the role of topical agents as adjuvants to biological treatments in the treatment of psoriasis and identify areas for further research. A MEDLINE search was performed in order to identify English-language publications from 1996 to 2014 examining combination biologic therapy with topical medications in the treatment of psoriasis. Data from these clinical studies are summarized and the outcomes are discussed. In general, the addition of adjuvant topical therapy to systemic biologic therapy allowed for a reduction in dosage and side effects of both agents, maintenance of initial response to biologics, treatment of recalcitrant lesions in partial responders, and potential acceleration of response to biologic therapies. The current data, though limited, suggest that using topical therapies as adjunct treatment to biologics is a well tolerated and effective means of controlling psoriasis and improving quality of life for patients. However, the treating physician should remain attentive to signs of adverse events and seek opportunities to reduce the dose or treatment frequency during chronic use.

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Acknowledgements

JD Jensen, MR Delcambre, G Nguyen and N Sami have no relevant financial and/or other conflicts of interest to report. No funds were used to support the writing of this manuscript.

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Authors and Affiliations

  1. Department of Dermatology, University of Alabama at Birmingham, EFH 414, 1530 3rd Ave, South Birmingham, AL, 35294-0009, USA

    J. Daniel Jensen & Naveed Sami

  2. Department of Dermatology, Oregon Health & Science University, Portland, OR, USA

    Macey Renault Delcambre

  3. Department of Dermatology, University of Michigan, Ann Arbor, MI, USA

    Gloria Nguyen

  4. Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA

    Naveed Sami

Authors
  1. J. Daniel Jensen
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  2. Macey Renault Delcambre
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  3. Gloria Nguyen
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  4. Naveed Sami
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Correspondence to Naveed Sami.

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Jensen, J.D., Delcambre, M.R., Nguyen, G. et al. Biologic Therapy with or Without Topical Treatment in Psoriasis: What Does the Current Evidence Say?. Am J Clin Dermatol 15, 379–385 (2014). https://doi.org/10.1007/s40257-014-0089-1

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